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Acute aortic dissection presenting as painless paraplegia: a case report
Olfa Hdiji1, Nouha Bouzidi2, Mariem Damak2
1Department of Neurology, Habib Bourguiba Hospital, CP: 3029, Sfax, Tunisia. olfahdiji@yahoo.fr.
Journal of Medical Case Reports
|April 20, 2016
Summary
Acute aortic dissection, a life-threatening condition, can present as painless paraplegia. Early diagnosis through clinical examination, including pulse and blood pressure checks, is crucial for survival.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Emergency Medicine
Background:
- Acute aortic dissection is a medical emergency typically causing severe chest pain.
- Spinal cord ischemia leading to paraplegia occurs in 2-5% of aortic dissection cases.
- Painless paraplegia as a presentation of aortic dissection is exceptionally rare.
Observation:
- A 70-year-old man presented with painless paraplegia and urinary retention.
- Neurological exam revealed flaccid paraplegia; vital signs were normal.
- Autopsy confirmed Type A aortic dissection extending to spinal arteries.
Findings:
- The case highlights a rare presentation of aortic dissection.
- Painless paraplegia can be a symptom of acute aortic dissection.
- Autopsy revealed aortic dissection with extension to intercostal and lumbar arteries.
Implications:
- Aortic dissection must be considered in patients with painless paraplegia.
- Thorough clinical examination, including peripheral pulse and blood pressure assessment, is vital.
- Prompt diagnostic imaging (CT or MRI angiography) is essential for early diagnosis and treatment.
